基于医保政策目标的基本医保定点医疗机构履约考核理论框架构建  

Construction of a Theoretical Framework for the Performance Assessment of Basic Medical Insurance Designated Medical Institutions Based on the Objectives of Medical Insurance Policy

作　　者：王倩 戴瑞明[3] 柯林 曹崚 章卫 沈孟娇 张天天 罗力 Wang Qian;Dai Ruiming;Ke Lin(School of Social Development and Public Policy,Fudan University,Shanghai,200433,China;不详)

机构地区：[1]复旦大学社会发展与公共政策学院,上海200433 [2]复旦大学老龄研究院,上海200433 [3]复旦大学公共卫生学院,上海200032 [4]上海市医疗保险事业管理中心,上海200125

出　　处：《中国医院管理》2024年第1期78-82,共5页Chinese Hospital Management

基　　金：教育部哲学社会科学研究重大课题攻关项目(20JZD027)。

摘　　要：系统梳理国内政策文件资料,分析我国基本医保制度的发展历程和政策目标演变,并以此为基础确定基本医保定点医疗机构履约考核目标,构建以政策目标实现为导向的考核维度框架。研究从契约管理和绩效管理的视角出发,分析基本医保定点医疗机构履约考核系统的构成要素及要素之间的逻辑关系,构建基本医保定点医疗机构履约考核系统理论模型,为指导基本医保定点医疗机构履约考核研究的开展提供参考。It collected relative policy documents systematically and analyzed the development process and policy objective evolution of Chinese basic medical insurance system.Based on this,it determined the performance assessment objectives of the designated medical institutions of basic medical insurance and constructed the assessment framework guided by the goal realization.Then,from the perspective of contract management and performance management,it determined the assessment elements of contract enforcement assessment system of designated medical institutions and the logical relationship between the elements,and to construct a conceptual model,which provides a reference for guiding the research of the contract enforcement assessment of the designated medical institutions of basic medical insurance.

关 键 词：基本医保 定点医疗机构 履约考核 理论模型 

分 类 号：R197.1[医药卫生—卫生事业管理]